Valentine’s Day — the ultimate season for romance. Instead of the usual (perishable) chocolates and flowers for your Valentine this year however, what about a gift that shows your commitment to building your future family?
Enter fertility preservation: the process of freezing eggs, sperm, or other reproductive tissue in the hopes of conceiving at a later date.
For couples hoping to start a family of their own one day, the question of when that day should be can be complex. Between building up careers, securing financial stability, and even gut feelings of being unprepared for the journey just yet, the question of when to have children can be further fraught with uncertainty thanks to biology. This is especially the case for women, who are constantly reminded of their “time limit” for having babies.
“Every woman is capable of producing a finite number of eggs in her lifetime, and the quality and quantity of these declines with age,” explains Dr Aldrin Lie, Medical Director, Consultant Obstetrician & Gynaecologist, Fertility Specialist of TMC Fertility. “The sharpest decline occurs after the age of 35 – while it’s not impossible to conceive at a later age, it can be a harder process for many.”
It’s unsurprising then that egg freezing in particular has become a mainstream idea. It’s now a common employee perk in Silicon Valley, with tech giants like Facebook and Apple offering coverage for the procedure. Celebrities such as Kim and Kourtney Kardashian have candidly talked about their experiences with egg freezing — or in the case of Jennifer Anniston, expressed regret at not having it done sooner.
As Dr Lie further explains, fertility preservation gives people a fresh perspective on parenthood by allowing them to take charge of their fertility. “In so many other areas of healthcare, we’re proactive — we watch our diets and stay fit to keep chronic disease at bay. Yet with fertility, we tend to only take action when a problem arises. Methods like egg and sperm freezing gives people an option of increasing their odds,” he says.
What exactly is egg freezing, and how does it work?
Also known as oocyte cryopreservation, egg freezing involves retrieving and storing a woman’s eggs in order to be used for conception at a later time. The method was first introduced in the 1980s as a way of offering women with serious medical conditions a chance at having children after completing treatment for their illness.
Before you rush out to put your ovaries on ice, bear in mind that there’s a step-by-step process to go through — starting with a simple consultation with the doctor. This will include an examination and series of tests to assess your ovarian reserve (the total number of healthy eggs in the ovaries) to see if you’re a good fit for the procedure.
After results are in and cleared, you’ll undergo ovarian stimulation; here, hormone injections are administered for around two weeks to help the ovaries produce more eggs. “On average, a woman will release one egg per month during their ovulation cycle,” says Dr Lie. “By encouraging a greater number of eggs, we have a better chance of retrieving ones that are suitable for future use, and have a greater reserve of usable eggs when they’re ready to be thawed.”
Once the eggs have matured, they are collected from the ovaries via a trans-vaginal procedure. This involves using a fine needle attached to an ultrasound-guided probe, which is gently passed through the ovaries. While the idea of needles poking around your tender lady parts can be anxiety-inducing, Dr Lie assures that the process is a pain-free one. “Egg retrieval is usually carried out under some form of light sedation. Under the hands of a well-trained medical professional, you should only feel some mild discomfort,” he says.
The final step is vitrification — a specialised procedure where the eggs are rapidly frozen using substances that prevent ice crystals from forming. “According to Dr Lie, the eggs can then be stored for up to 10 years, ready to be de-thawed when a couple is ready to embark on their journey to parenthood.
Sperm on the rocks, anyone?
Men, if you’re feeling left out of the fertility discourse, don’t fret — science now says that you have a biological clock too. While men’s fertility decline happens more gradually, studies show that ageing can affect semen volume, and sperm quality in terms of motility (movement) and genetic abnormalities.
One study reviewing over 40 years of research on male fertility in the United States found that men aged 45 and above are at a higher risk of having babies with birth defects such as congenital heart disease. Older fathers may also increase their partners’ risk of developing pregnancy complications.
Men too can “freeze” their fertility through sperm banking, where semen is frozen and stored for future use. Similar to the egg freezing process, you’ll first undergo a health screening to make sure you’re free from any infectious diseases, before a semen sample is collected.
The semen collection part may make some men uncomfortable — there’s nothing less sexy than trying to efficiently masturbate into a plastic cup in a clinical room. However, medical staff are trained to be discrete and will have likely encountered all sorts of bodily fluids in their line of work. In most cases, you’ll be led to a private room and be left to complete the task at hand (pun intended).
The sample is analysed to assess the health and quantity of sperm available for freezing, before being put into a special freezing solution. Finally, the prepared samples are stored in freezers that contain liquid nitrogen to preserve the sperm. It is said that sperm can be stored indefinitely without any ill-effects.
Risks, misconceptions, and new breakthroughs
As with any medical procedure, there is some risk to freezing your eggs. One possible complication is a condition called ovarian hyperstimulation syndrome (OHSS). This condition occurs when the hormones used to stimulate the development of eggs cause the ovaries to swell. Symptoms can range in severity, and include abdominal pain, nausea, and vomiting.
“Although severe and critical OHSS is very uncommon, it’s advisable that women consult reputable and experienced professionals when considering any fertility procedure,” cautions Dr Lie. “A good health provider will be able to not only assess the risk profile of the patient, but also continuously monitor their health throughout the process to look out for any adverse reactions.”
What is more myth than risk is the idea that egg freezing and retrieval affects the number of eggs a woman produces in her lifetime. “This can’t happen, as we only retrieve the eggs that are available at the time of collection”, explains Dr Lie.
Another misconception is concern over the health of infants born from frozen eggs. Research carried out so far however, including a study of over 900 babies, shows that there is no significant difference between babies from fresh or frozen eggs.
Aside from simply freezing your reproductive material, some fertility centres have even introduced more advanced ways of assessing your health at a deeper level. TMC Fertility, for instance, has two genetics-based tests called Fertility GeneCode and My GeneCode, which offer insights into your risk of passing on hereditary diseases to your future child. “Tests like these can also give people a better picture of why they may be experiencing fertility issues, allowing them to seek the treatment they need,” adds Dr Lie.
While the decision to freeze one’s eggs or sperm is a highly personal one, it’s worth thinking about future-proofing your fertility regardless of whether you’re single or partnered. “Fertility preservation methods can’t offer a guarantee, but they can definitely increase your odds at conceiving,” says Dr Lie. “In that sense, it can help with easing the stress of ‘when’ you should have children, and give you some breathing room in making the right choice for your circumstances.”